CN210158688U

CN210158688U - Atlantoaxial dislocation posterior repositor

Info

Publication number: CN210158688U
Application number: CN201821593350.3U
Authority: CN
Inventors: 马向阳
Original assignee: Southern Theater Command General Hospital of PLA
Current assignee: Southern Theater Command General Hospital of PLA
Priority date: 2018-09-28
Filing date: 2018-09-28
Publication date: 2020-03-20
Anticipated expiration: 2028-09-28

Abstract

The utility model provides an atlantoaxial dislocation posterior restorer, which comprises a fixed arm and a sliding arm which are connected in a cross way, wherein the fixed arm and the sliding arm are provided with vertical bends at the same height; a hook is arranged at the front section of the sliding arm, and the hook can controllably slide back and forth at the front end of the sliding arm through a sliding module; and a fixing module fixed with a vertebral body is arranged in front of the fixing arm. The sliding arm and the fixed arm are connected with the atlantoaxial, the fixed module on the fixed arm is used for fixing the atlantoaxial, the sliding module on the sliding arm is used for pulling back the dislocated atlantoaxial for resetting, and then the fixing and bone grafting operations are carried out, so that the resetting of the anterior dislocated atlantoaxial from the posterior is realized.

Description

Atlantoaxial dislocation posterior repositor

Technical Field

The utility model relates to the field of medical equipment, in particular to an atlantoaxial dislocation posterior restorer.

Background

The atlas and the axis are the first and the second cervical vertebrae of a human body, and the dislocation of the atlas and the axis caused by any reason can cause the spinal cord to be pressed, so that limbs are numb and powerless, even paralysis and death occur; the key of the atlantoaxial dislocation treatment is to realize atlantoaxial reposition and relieve spinal cord compression. Atlantoaxial dislocation is classified into 3 types, including reversible type, difficult-to-reverse type and irreversible type, according to the difficulty of restoration. Wherein, the reduction can be carried out after the compound traction, and only firm fixation and reliable bone grafting fusion are carried out in the reduction state; the irreparable atlantoaxial type can hardly reset due to the existence of bony connection and fusion between atlantoaxial bodies, and the nerve compression is mostly relieved by directly removing the compression tissue clinically, but the difficulty is high and the risk is high; for difficult-to-reposition dislocation, although the existing atlantoaxial posterior pedicle screw rod fixing technology has a certain lifting and resetting function, the resetting resistance caused by scar tissues formed after dislocation is often larger than the lifting and resetting force of a screw rod system, so that the simple screw rod resetting is often not good. Therefore, in order to realize the dislocation of the atlantoaxial which is difficult to renature, the soft tissue scar in front of the atlantoaxial is often required to be firstly subjected to the operation of loosening through the oral cavity, and then the nail rod is used for fixing, lifting and resetting, although a certain effect is obtained, the operation difficulty and the complexity are increased. Theoretically, if no bony connection and fusion exist between the dislocated atlantoaxial bones, the reposition can be realized as long as the reposition strength is greater than the scar constraint resistance, so that the complicated oral scar loosening operation is avoided. Therefore, if the inner fixing nail rod is provided with an additional surgical instrument device for increasing the resetting force besides the lifting resetting force, the resetting is further promoted, and the operation difficulty is greatly reduced.

Clinically, according to the direction of the dislocation of the atlas, the anterior dislocation of the atlas is most common, i.e. the dislocation of the atlas is in two directions, namely anterior and inferior, which is about more than 95%. The reduction of difficult renaturation atlas dislocation mainly adopts the operation of reducing again after the anterior approach is loosened at present, it needs to enter from patient's oral cavity to carry out at the throat opening, and this operation is very big on the one hand, and on the other hand, the oral cavity enters the scope and is little, has also improved the degree of difficulty of operation.

SUMMERY OF THE UTILITY MODEL

The utility model provides an atlantoaxial dislocation posterior restorer for atlantoaxial dislocation, which solves the operation difficulty brought by anterior restoration in the prior art.

The technical scheme of the utility model is realized like this: an atlantoaxial dislocation posterior repositor comprises a fixed arm and a sliding arm which are connected in a cross way, wherein the fixed arm and the sliding arm are provided with vertical bends at the same height; a hook is arranged at the front section of the sliding arm, and the hook can controllably slide in the front-back direction at the front end of the sliding arm through a sliding module; and a fixing module fixed with a vertebral body is arranged in front of the fixing arm. The utility model discloses a slide module, slide module includes slider and screens device, the hook is fixed and is had the slip tooth on the slider, the slider passes through the screens device is fixed on the sliding arm, the screens device is including being used for draw-in groove and pivot that the slider passed, pivot one end is located inside the screens device, and through the gear with the slider meshing, other end break-over screens device outer wall to be fixed with the rotation handle, with the pivot level is provided with the stopping piece, the embedding of stopping piece one end the slip intertooth, the middle part is fixed through the bolt on the screens device the bolt with still be equipped with the torsional spring between the stopping piece, make the stopping piece is in the embedding the state between the slip intertooth. The front end of the fixing arm of the fixing module is divided into two fork arms, pore channels are formed in the fork arms, and threads are formed in the pore channels.

The atlantoaxial dislocation posterior restorer, through the sliding arm connection control dislocation atlas, through on the fixed arm fixed module fixes the axis, the rethread sliding module on the sliding arm pulls back the atlantoaxial that dislocates and resets, then plants the bone operation, realizes the reposition to dislocation atlantoaxial in the front and back direction.

Furthermore, the middle part of the fork arm is provided with a spinous process pore canal which forms an included angle of 50-70 degrees with the central line of the spinous process, and the spinous process pore canal is internally provided with threads. When the fixing nail with external screw thread is screwed in along the spinous process pore canal, the fork arm can be fixed on the spinous process of the epistropheus, thus playing the role of preventing the fork arm from sliding.

Furthermore, the atlantoaxial dislocation posterior repositor also comprises a screw which passes through the pore canal and/or the spinous process pore canal, and the screw is provided with external threads and is accompanied with scales, so that the screw can be prevented from being screwed too deep into the vertebral canal to injure the spinal cord.

Further, the fixed arm with the below formation handle of slip arm cross connection department, be equipped with stop device between the handle, stop device includes threaded rod and stop nut, threaded rod one end is passed through the connecting piece and is fixed on one of them handle, corresponds to and is equipped with the through-hole on another handle, the other end of threaded rod passes the through-hole, the stop nut cover is established on the threaded rod and be located two between the handle. Thereby reducing and controlling the opening amplitude between the atlas posterior arch and the axis vertebral plate when the handle is pressurized and closed, and realizing the good reduction of the atlas in the head-tail direction.

As another optional mode, the utility model discloses a still put forward another structure to the sliding module, wherein, including fixing sliding tube and the threaded rod on the slide arm, the afterbody of hook embolias in the sliding tube, the threaded rod embolias from the other end of sliding tube in the sliding tube to through the screw thread with the sliding tube is connected, the threaded rod with the hook is in sliding tube internal connection, threaded rod bottom periphery is equipped with annular groove, forms the connector, the hook afterbody is equipped with the aperture, aperture entrance diameter is greater than annular groove portion diameter and is less than the diameter of connector, the inside diameter of aperture is greater than the diameter of connector, the connector embolias in the aperture, through rotating the threaded rod, realize the threaded rod is in sliding tube moves, and then the hook is dragged to move to realize the reset movement in the reset process.

Furthermore, the side wall of the sliding pipeline is provided with a strip-shaped window, the tail of the hook is provided with a side wall positioning screw hole, the opening direction of the side wall positioning screw hole faces the window, and a positioning screw is arranged on the side wall positioning screw hole and passes through the side wall positioning screw hole and the positioning screw, so that the hook is prevented from rotating along with the rotation of the threaded rod when moving.

The atlantoaxial dislocation posterior repositor realizes the reposition operation of the anterior atlantoaxial dislocation from the posterior, reduces the difficulty of the reposition operation, reduces the risk of the operation of a patient, and has controllable operation process and higher safety.

Drawings

In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings needed to be used in the description of the embodiments or the prior art will be briefly described below, it is obvious that the drawings in the following description are only some embodiments of the present invention, and for those skilled in the art, other drawings can be obtained according to these drawings without inventive exercise.

FIG. 1 is a schematic perspective view of an embodiment of the atlantoaxial dislocation posterior repositor of the present invention;

FIG. 2 is a schematic structural view of one side of the atlantoaxial dislocation posterior repositor shown in FIG. 1;

FIG. 3 is a schematic structural view of the other side of the atlantoaxial dislocation posterior repositor shown in FIG. 1;

FIG. 4 is a schematic structural view of the other side of the atlantoaxial dislocation posterior repositor shown in FIG. 1 (dorsal surface);

FIG. 5 is a schematic structural view of the other side surface (top surface) of the atlantoaxial dislocation posterior repositor shown in FIG. 1;

fig. 6 is a schematic structural view of the yoke 12;

FIG. 7 is a schematic diagram of the fixing and displacement of the fixed arm and the sliding arm when the fixed arm and the sliding arm restore the dislocated atlantoaxial cone;

fig. 8 is a schematic structural diagram of another embodiment of the present invention;

FIG. 9 is a partial schematic view of the connection of a threaded rod to a sliding tube and a hook according to another embodiment of the present invention;

FIG. 10 is a partial cross-sectional view of another embodiment of the invention showing the connection of a threaded rod to a sliding tube and hook;

fig. 11 is an enlarged view of the connection between the threaded rod and the hook according to another embodiment of the present invention.

Detailed Description

The technical solutions in the embodiments of the present invention will be described clearly and completely with reference to the accompanying drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only some embodiments of the present invention, not all embodiments. Based on the embodiments in the present invention, all other embodiments obtained by a person skilled in the art without creative efforts belong to the protection scope of the present invention.

An atlantoaxial dislocation posterior repositor comprises a fixed arm 1 and a sliding arm 2 which are connected in a cross way, wherein the fixed arm 1 and the sliding arm 2 are provided with vertical bends at the same height; a hook 21 is arranged at the front section of the sliding arm 2, and the hook 21 can controllably slide in the front-back direction at the front end of the sliding arm 2 through a sliding module 3; a fixing module 11 fixed with the vertebral body is arranged in front of the fixing arm 1. Specifically, the sliding module 3 includes a slider 31 and a detent device 32, the hook 21 is fixed on the slider 31 with sliding teeth, the slider 31 is fixed on the sliding arm 2 through the detent device 32, the detent device 32 includes a slot and a rotating shaft 33 for the slider 31 to pass through, one end of the rotating shaft 33 is located inside the detent device 32 and is engaged with the slider 31 through a gear, the other end of the rotating shaft passes through the outer wall of the detent device 32 and is connected and fixed with a rotating handle, a check plate 34 is horizontally arranged with the rotating shaft 33, one end of the check plate 34 is embedded into the sliding teeth, the middle part of the check plate is fixed on the detent device 32 through a bolt, and a torsion spring (not shown) is further arranged between the bolt and the check plate 34, so that the check plate is in a state of being embedded into. The fixing module 11 is a fixing arm whose front end is divided into two fork arms 12, and the fork arms 12 are provided with hole channels, and the hole channels are provided with screw threads (shown in fig. 6).

The utility model discloses an atlantoaxial dislocation back way restorer through 2 connection control dislocation atlas of sliding arm, fixes the axis through the fixed module on the fixed arm 1, and the atlas that slides module 3 on the rethread sliding arm will dislocate draws back the reposition, then fixes and plants the bone operation again, realizes the reposition to dislocation atlas on the front and back side.

In order to further improve the fixing effect, a spinous process duct 13 (shown in fig. 6) which forms an included angle of 50-70 degrees with the central line of the spinous process can be arranged at the middle part of the yoke 12, and threads are arranged in the spinous process duct 13. When the fixing nail with external threads is screwed in along the spinous process pore canal 13, the fork arm 11 can be fixed on the dentate spinous process, thereby achieving the effect of preventing the fork arm 11 from sliding.

Furthermore, the atlantoaxial dislocation posterior repositor also comprises a screw which passes through the pore canal and/or the spinous process pore canal 13, and the screw is provided with external threads and is accompanied with scales, so that the screw can be prevented from being screwed too deep into the vertebral canal to injure the spinal cord.

Further, a handle is formed below the cross connection position of the fixed arm 1 and the sliding arm 2, a limiting device is arranged between the handles and comprises a threaded rod 4 and a limiting nut 5, one end of the threaded rod 4 is fixed on one of the handles through a connecting piece and corresponds to the other handle, a through hole is formed in the other end of the threaded rod 4, and the limiting nut 5 is sleeved on the threaded rod 4 and located on the outer side of the through hole. The atlantoaxial opening bracing device can prevent the repositor from being compressed after being stressed by the limiting nut 5 after the atlantoaxial opening bracing device is propped open. In addition, a second limit nut (not shown) can be added between the two handles, so that the opening range between the atlas posterior arch and the axis vertebral plate can be reduced and controlled when the handles are closed by pressurization, and the good reduction of the atlas in the head-tail direction can be realized.

As shown in fig. 8-11, as another alternative, the utility model provides another structure for the sliding module, wherein, the sliding module comprises a sliding pipe 6 fixed on the sliding arm 2 and a threaded rod 7, the tail of the hook 21 is inserted into the sliding pipe 6, the threaded rod 7 is provided with an external thread, and in this embodiment, the top is further provided with a part facilitating to grasp and expand, the threaded rod 7 is inserted into the sliding pipe 6 from the other end of the sliding pipe 6 and is connected with the sliding pipe 6 through a thread, the threaded rod 7 is connected with the hook 21 in the sliding pipe 6, the periphery of the bottom of the threaded rod 7 is provided with an annular groove to form a connecting head 71, the tail of the hook 21 is provided with a small hole 211, the diameter of the inlet of the small hole 211 is larger than the diameter of the annular groove and smaller than the diameter of the connecting head 71, the diameter of, the sleeving mode can adopt a mode that a gap is formed in the side wall to sleeve the connecting head 71, then the connecting head 71 is closed, or the connecting head is not closed, but the horizontal movement of the threaded rod and the hook is limited to prevent the connecting head 71 from sliding out of the small hole 211, the threaded rod 7 is rotated to move in the sliding pipeline 6, and then the hook 21 is dragged to move to realize the reset movement in the reset process.

Furthermore, the side wall of the sliding pipeline 6 is provided with a strip-shaped window 61, the tail part of the hook 21 is provided with a side wall positioning screw hole 212, the opening direction of the side wall positioning screw hole 212 faces the window 61, and the side wall positioning screw hole 212 is provided with a positioning screw which passes through the side wall positioning screw hole 212 and the positioning screw (not shown in the figure), so that the hook is prevented from rotating along with the rotation of the threaded rod when moving and affecting the operation.

The following is a detailed description of the use process:

the atlantoaxial dislocation posterior repositor has huge reposition force for lifting the atlantoaxial and pressing the atlantoaxial downwards, and the composition and the reposition process are realized as follows: the atlantoaxial dislocation posterior repositor is similar to a pincer in appearance, the front part of the atlantoaxial dislocation posterior repositor consists of two repositioning arms, one repositioning arm is a sliding arm 2, the sliding arm 2 and an atlantoaxial dislocation posterior repositor main body are integrated, the foremost end of the sliding arm 2 is provided with a hook 21, the hook 21 is connected with a sliding module 3, the hook 21 can hook the posterior arch of the atlantoaxial or a transverse connecting rod placed between two atlantoaxial screws, a screw thread-shaped sliding module device is arranged between the sliding module 3 and the sliding arm 2, when a rotating handle on the sliding module 3 is rotated, the sliding module 3 slides backwards one grid of screw thread along the sliding arm 2 every time, and an automatic retaining device (retaining sheet 34) is arranged, when the sliding module 3 slides backwards, the hook 21 drives the atlantoaxial to move backwards, so that the atlantoaxial reposition is realized by gradually lifting the atl. The other reset arm of the atlantoaxial dislocation posterior repositor is a fixed arm 1, the front part of the atlantoaxial dislocation posterior repositor is divided into a left fork arm 11 and a right fork arm 11, the foremost end of each fork arm 11 is slightly arc-shaped and is placed at the junction of the centrum vertebra plate and the inner lower edge of the lateral mass, the whole length of each fork arm 11 is internally provided with a hole channel, a thread is arranged in the hole channel, when a fixing nail with the thread outside is screwed along the hole channel, the fork arms can be fixed on the centrum lateral mass, and the fixing nail is provided with scales so as to; meanwhile, the middle parts of the left fork arm and the right fork arm 11 are respectively provided with a spinous process pore canal 13 which forms an included angle of 60 degrees (outer upper inclined inner lower) with the central line of the spinous process, the spinous process pore canal 13 is also internally provided with threads, and the fork arms can be fixed on the spinous process of the epistropheus when a fixing nail with outer threads is screwed along the pore canals, and the two fork arm screw fixing modes can both play the effect of preventing the fork arms 11 from sliding, so that the fixing arm 1 and the epistropheus are firmly fixed into a whole. Therefore, when the sliding module 3 hooked on the atlas slides backwards, the fork arm 11 fixed on the axis generates the acting force of pressing down the axis to promote the further restoration of the atlas in the front and back direction. The two handles are arranged at the rear of the repositor, a pressurizing closing screw thread is arranged between the two handles, when the limiting nut 5 is rotated, the two handles at the rear tend to be closed, and meanwhile, the two repositioning arms at the front are also closed at equal intervals, so that the distance and the included angle between the atlantoaxial posterior nodule and the axis vertebral plate which are increased due to dislocation are recovered, and the reposition of the atlantoaxial in the head-tail direction is realized.

During operation, firstly, pedicle screws are respectively placed in the atlantoaxial, fixing rods are placed on two sides of the atlantoaxial, nuts of the atlantoaxial screws are screwed down firstly, then the atlantoaxial posterior repositor is placed, the atlantoaxial is pulled backwards by the repositor, the atlantoaxial is pushed forwards to generate resetting force, the nuts of the atlantoaxial screws are gradually screwed to generate pulling resetting force of the nail rod fixing system, the combination of two resetting forces of the repositor and the nail rod system can generate large enough resetting force, therefore, the binding resistance of scars is overcome, good resetting is realized, the atlantoaxial screw nut is locked finally, the repositor is taken out, and the resetting process is.

The fixing arm and the sliding arm are used for fixing and displacing the dislocated atlas pivot cone as shown in fig. 7, wherein the fixing arm 1 plays a role in fixing, and the sliding arm 2 is used for pulling backwards to restore the dislocated atlas cone.

The above description is only a preferred embodiment of the present invention, and should not be taken as limiting the invention, and any modifications, equivalent replacements, improvements, etc. made within the spirit and principle of the present invention should be included in the protection scope of the present invention.

Claims

1. The utility model provides an atlantoaxial dislocation way of escape restorer which characterized in that: the device comprises a fixed arm and a sliding arm which are connected in a cross manner, wherein the fixed arm and the sliding arm are provided with vertical bends at the same height; a hook is arranged at the front section of the sliding arm, and the hook can controllably slide in the front-back direction at the front end of the sliding arm through a sliding module; and a fixing module fixed with a vertebral body is arranged in front of the fixing arm.

2. The atlantoaxial dislocation posterior repositor of claim 1, wherein: the sliding module includes slider and screens device, the hook is fixed and is having the slip tooth on the slider, the slider passes through the screens device is fixed on the sliding arm, the screens device is including being used for draw-in groove and pivot that the slider passed, pivot one end is located inside the screens device, and through the gear with the slider meshing, other end break-over screens device outer wall to be fixed with the rotation handle to the connection, with the pivot level is provided with the backstop piece, the embedding of backstop piece one end in the middle of the bayonet socket of slip tooth, the middle part is fixed through the bolt on the screens device the bolt with still be equipped with the torsional spring between the backstop piece, make the backstop piece is in the embedding state in the middle of the bayonet socket of slip tooth.

3. The atlantoaxial dislocation posterior repositor of claim 1, wherein: the front end of the fixing arm of the fixing module is divided into two fork arms, pore channels are formed in the fork arms, and threads are formed in the pore channels.

4. The atlantoaxial dislocation posterior repositor of claim 3, wherein: the middle part of the fork arm is provided with a spinous process pore canal which forms an included angle of 50-70 degrees with the central line of the spinous process, and the spinous process pore canal is internally provided with threads.

5. The atlantoaxial dislocation posterior repositor of claim 4, wherein: the screw is provided with external threads and is accompanied with scales.

6. The atlantoaxial dislocation posterior repositor of claim 1, wherein: the fixed arm with the below formation handle of slip arm cross connection department, be equipped with stop device between the handle, stop device includes threaded rod and stop nut, threaded rod one end is passed through the connecting piece and is fixed on one of them handle, corresponds and is equipped with the through-hole on another handle, the other end of threaded rod passes the through-hole, stop nut overlaps and establishes on the threaded rod and be located two between the handle.

7. The atlantoaxial dislocation posterior repositor of claim 1, wherein: the sliding module is including fixing slip pipeline and the threaded rod on the slide arm, the afterbody of hook embolias in the slip pipeline, the threaded rod is followed the other end of slip pipeline embolias in the slip pipeline to through the screw thread with the slip pipe connection, the threaded rod with the hook is in slip pipeline internal connection, threaded rod bottom periphery is equipped with the annular groove, forms the connector, the hook afterbody is equipped with the aperture, aperture entrance diameter is greater than annular groove part diameter and is less than the diameter of connector, the inside diameter of aperture is greater than the diameter of connector, the connector embolias in the aperture.

8. The atlantoaxial dislocation posterior repositor of claim 7, wherein: the side wall of the sliding pipeline is provided with a strip-shaped window, the tail of the hook is provided with a side wall positioning screw hole, the opening direction of the side wall positioning screw hole faces towards the window, and the side wall positioning screw hole is provided with a positioning screw.